PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/15 days

Consanguinity

Neck holding

Food preferences

Mixed

HR

Neuropsychiatric condition

Place of Birth

Hospitalization

Tactile

PatientId

3f8af7dd-82d7-4239-b241-65470fe12e04

FollowUpId

997da245-4ddb-43e6-a13b-f5f8220ae450

Child's Name

Shivansh Singh Tomar

Age

2 Year 6 Month 11 Days

Gender

Male

DOB

2024-02-02

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Number of family members

Number of siblings

Details of siblings (Age and sex)

Address

Contact

9806709042

Referred By

Informant

Chief concerns

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Improved with family members

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Hand flapping

Patterned behavior or activities

If yes- Details

Others

Details:

Biting

Impression

ASD

Hopes from the consultation